Many children with severe inflammatory disease had no symptoms of Covid-19 disease, and those with only mild symptoms, according to a new US study.
Many children with severe inflammatory disease had no symptoms of Covid-19 disease, and those with only mild symptoms, according to a new US study.
According to results published Tuesday in JAMA Pediatrics of the largest US study of cases of multisystem inflammatory syndrome (MIS-C) in children, which can strike young people weeks after being infected with Covid-19.
Many children and adolescents who have developed the mysterious inflammatory syndrome that can appear weeks after contracting the coronavirus have never exhibited classic symptoms of Covid-19 at the time of their infection, the study says.
According to the New York Times, the study, led by researchers from the Centers for Disease Control and Prevention, found that in more than 1,000 cases for which information about the initial illness of Covid-19 was available, 75% of patients did not show such symptoms.
However, two to five weeks later, they became sick enough to be hospitalized for the condition called multisystem inflammatory syndrome in children (MIS-C), which can affect multiple organs, especially the heart.
The study said that “most MIS-C illnesses are thought to result from asymptomatic or mild Covid-19” followed by a hyper-inflammatory response that appears to occur when patients’ bodies have produced their peak level of d antibodies against the virus.
However, experts have not been able to table concrete conclusions on the reason for such a high rate of inflammatory syndrome in young children.
“This means that primary care pediatricians must have a high index of suspicion, because Covid is so prevalent in society and children often have asymptomatic illness like their initial infection with Covid,” said Dr Jennifer Blumenthal, intensive care pediatrician and pediatric. infectious disease specialist at Boston Children’s Hospital, who was not involved in the study.
The researchers evaluated 1,733 of the 2,090 cases of the syndrome in people aged 20 and under that had been reported to the CDC in January.
The results show that although the syndrome is rare, it can be serious. CDC data included only hospitalized patients. More than 90 percent of these young people experienced symptoms affecting at least four organ systems and 58 percent required treatment in intensive care units.
Many suffered from significant heart problems: more than half developed low blood pressure, 37% cardiogenic shock, and 31% cardiac dysfunction involving the inability of their heart to pump properly.
The study further said that a significantly higher percentage of patients who had not shown symptoms of Covid-19 experienced these heart problems, compared to those who had initial symptoms of coronavirus.
A larger percentage of initially asymptomatic patients also ended up in intensive care, the New York Times reported.
“Even children with severe MIS-C, who were in intensive care – the vast majority of them did not have a previous illness that they recognized,” said Dr Roberta DeBiasi, head of infectious diseases at the Children’s National Hospital in Washington, DC, which was not involved in the research.
The study provided the most detailed demographic and geographic picture of the syndrome to date.
About 34% of the patients were black and 37% were Hispc, reflecting how the coronavirus has disproportionately affected members of these communities.
As the pandemic has progressed, the authors wrote, the proportion of white patients has increased, accounting for 20% of all cases. People of Asian descent made up just over 1% of patients.
Overall, almost 58% of patients were men, but the proportion was not the same at all ages. The youngest group – from newborn to age 4 – had roughly the same number of boys and girls, and the male-to-female ratio increased in the older groups until it is more than two for a man per woman in the 18 years. group at-20.
The vast majority of patients (almost 86 percent) were under 15 years of age. The study found that children under 5 had the lowest risk of serious heart complications and were less likely to need intensive care. Patients 10 years of age and older were significantly more likely to develop problems such as shock, low blood pressure, and myocarditis (inflammation of the heart muscle).
“I think it’s similar to what we’ve seen with Covid, that older children seemed to have more serious illness,” Dr DeBiasi said. “And that’s because what makes people really sick with Covid is the inflammatory aspect of it, so maybe these older kids, for whatever reason, are having more inflammation, than whether in the primary Covid or the MIS-C. “
Children 14 and under were more likely to have rashes and red eyes, while those over 14 were more likely to experience chest pain, shortness of breath, and cough. Abdominal pain and vomiting affected about two-thirds of all patients.
There have been 24 registered deaths, spread across all age groups. There was no information in the study on whether patients had any underlying medical conditions, but doctors and researchers reported that young people with MIS-C were often previously healthy and much more likely to be in good health than the relatively small number of young people who become seriously ill from initial Covid infections.
Likewise, the reasons behind the study’s conclusion that during the first wave of MIS-C, from March 1 to July 1, 2020, young people were more prone to some of the more serious heart complications. Dr DeBiasi said this did not match his hospital experience, where “the children were sicker in the second wave”.
The study documented two waves of MIS-C cases that followed an increase of about a month or more in the total number of coronavirus cases. “The third most recent peak in the Covid-19 pandemic appears to lead to another MIS-C peak possibly involving urban and rural communities,” the authors wrote.
Dr Blumenthal said: “at the moment we don’t know anything about how the variants necessarily affect children”.
(With ANI entries)
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